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Objective: To evaluate adverse effects/postoperative complications and surgical response rate of maxillomandibular advancement for the treatment of severe obstructive sleep apnea syndrome., Study Design: Case series with chart review., Setting: Otolaryngology Head and Neck Surgery Department in a teaching hospital., Subjects and Methods: A total of 59 consecutive severe sleep apnea patients underwent maxillomandibular advancement. Systemic complications were evaluated from medical charts. Functional adverse effects and cosmetic consequences were evaluated by questionnaires. The treatment outcome was assessed by polysomnography., Results: Fifty patients were evaluated. They had a mean age of 46.4 +/- 9.0 years. No serious postoperative complication was observed. The most frequent local complication was mental nerve sensory loss. Most patients reported cosmetic changes. The mean apnea-hypopnea index decreased from 65.5 +/- 26.7 per hour to 14.4 +/- 14.5 per hour (P < 0.0001). Light-sleep stages were also decreased (P < 0.0001), whereas deep-sleep stages were increased (P < 0.001)., Conclusion: Maxillomandibular advancement can induce local adverse effects and cosmetic changes, but they seem to be considered as secondary to the patients according to the surgical outcome.

Objective: To compare the efficacy and safety of four radiofrequency generators (Ellman, Select Sutter, Coblator, Somnus) for the treatment of simple snoring., Materials and Methods: Multicenter, randomized, prospective single-blind study on 120 selected patients with simple snoring (apnea/hypopnea index <10/h of sleep). Snoring sound intensity was measured on a visual analog scale and the partner's short-term satisfaction rate was evaluated after two treatment sessions maximum. Discomfort, pain, and medication intake were compared., Results: Radiofrequency decreased the snoring sound intensity from 7.9 +/- 1.7 to 4.4 +/- 2.7 (P < 0.0001). The four radiofrequency generators had a statistically comparable efficacy. The Ellman generator caused less discomfort and required less anti-inflammatory drugs., Conclusion: Despite different technical characteristics, the four generators had a comparable efficacy with good safety. The Ellman generator induced the least discomfort.

Objectives: Because of the side effects of Teflon, the risk of infection from the use of collagen, autologous fat resorption, and the lack of alternative substances, injection laryngoplasty tends to be replaced by laryngeal framework surgery as the method of choice for the treatment of unilateral vocal cord recurrent paralysis (LP). The aim of this study was to evaluate the results, for morbidity and voice quality, of treating this paralysis by injection of a silicone suspension elastomer implant (SSEI)., Study Design: The study was retrospective, and 19 patients were included. Average follow-up was 25 months (range: 8.3-43)., Methods: Each patient underwent clinical and videostroboscopic assessment, and had an electroglottographic recording. Subjective assessment was obtained by self-evaluation. Results were classified as good, fair, or poor, and were based on 2 objective and 3 subjective criteria. A search was made for biologic signs of autoimmune disorders., Results: Good, fair, and poor results were respectively 79%, 16%, and 5%. Each set of subjective data showed voice improvement (P < 0.05). The fundamental frequency range, percentage of irregularity, and aspiration decreased significantly (P < 0.05). There was only one case of postoperative dyspnea, which resolved after steroid injection. No biologic signs of autoimmune disorders were found., Conclusions: The use of SSEI is safe. Injection laryngoplasty is easy to perform and avoids cervical scarring. Its results are comparable to those obtained with other techniques, including laryngeal framework surgery, even if there is no standard criterion for the evaluation of voice quality. SSEI injection can reasonably be proposed as a surgical treatment for permanent unilateral vocal cord LP.

Objective: To compare efficacy and tolerance of controlled temperature radiofrequency and laser-assisted uvulopalatopharyngoplasty (LAUP) for the treatment of snoring., Methods: This was a prospective, nonrandomized study on 30 patients who snored. All patients had a sleep night study. Only patients with simple snoring or mild sleep apnea and soft palate obstruction were included. Efficacy was subjectively evaluated by the bed partner 2 months after the last treatment. Tolerance was estimated daily by the patient during 18 first postoperative days. Discomfort, pain, medication intake, diet, and number of days off from work were assessed., Results: Both treatments were effective on snoring. Mean discomfort and pain as well as mean intake of analgesics were significantly greater with laser-assisted uvulopalatopharyngoplasty., Conclusion: Controlled temperature radiofrequency was as effective as laser-assisted uvulopalatopharyngoplasty on snoring on a short-term basis but was better tolerated.